title: Responsiveness to parenteral iron therapy in children with oral iron-refractory iron-deficiency anemia.
abstract: Intravenous (IV) ferric iron (Fe)-carbohydrate complexes are used for treating Fe deficiency in children with iron-refractory iron-deficiency anemia (IRIDA). An optimal treatment has yet to be determined. There are relatively little publications on the responsiveness to IV iron therapy in children with IRIDA.
  
  
  METHODS
  This study analyzed responses to IV iron sucrose therapy given to 11 children, ranging in age from 2 to 13 years (mean 4.8 years), with iron-deficiency anemia who were unresponsive to oral iron therapy.
  
  
  RESULTS
  The hemoglobin and ferritin values (mean) of the 11 children with IRIDA were 7.7 g/dL and 4.8 ng/mL at diagnosis. Both hemoglobin and ferritin levels increased to 9.5 g/dL, and 24 ng/mL, respectively, at 6 weeks after the first therapy. Although the level of hemoglobin was steady at 6 months after the first, and 6 weeks after the second therapy, the ferritin levels continued to increase up to 30 ng/mL and 47 ng/mL at 6 months after the first and 6 weeks after the second therapy, respectively.
  
  
  CONCLUSIONS
  We recommend that IRIDA should be considered in patients presenting with iron-deficiency anemia of unknown cause that is unresponsive to oral iron therapy. Our results suggest that IV iron therapy should be administered only once in cases of IRIDA. Continued administration of IV iron would be of no benefit to increase hemoglobin levels. On the contrary, ferritin levels may continue to increase resulting in untoward effects of hyperferritinemia.
authors.affiliation: Department of Pediatric Hematology, Denizli State Hospital , Denizli , Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Akin
authors.forename: Enver
authors.initials: E
authors.lastname: Atay
authors.forename: Osman
authors.initials: O
authors.lastname: Oztekin
authors.forename: Cem
authors.initials: C
authors.lastname: Karadeniz
authors.forename: Yasin Tugrul
authors.initials: YT
authors.lastname: Karakus
authors.forename: Bilal
authors.initials: B
authors.lastname: Yilmaz
authors.forename: Firat
authors.initials: F
authors.lastname: Erdogan
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004351:Drug Resistance; D004909:Erythrocyte Indices; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D000077605:Ferric Oxide, Saccharated; D005296:Ferrous Compounds / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D005937:Glucaric Acid; D006801:Humans; D007262:Infusions, Intravenous; D007501:Iron / Q000097:blood*; D008297:Male; D013395:Sucrose / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D005290:Ferric Compounds; D005296:Ferrous Compounds; C020748:ferrous sulfate; D013395:Sucrose; D007501:Iron; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid